To Salt or Not to Salt...

Jean was confused because her doctor had told her to cut out as much salt as possible from her diet. Yet the article suggested that too little salt was dangerous.

Her doctor’s view represents the ‘Conventional’ premise that a high intake of this mineral clogs our arteries, and increases hypertension and blood pressure.

Indeed, over the last 40 years both the British Medical Association (BMA) and National Institute for Health and Clinical Excellence (NICE) have conducted clinical trials and published papers showing that high salt intakes are directly linked with strokes and heart attacks. The recommendation is that adults don't eat more than 6g per day.

This view may now be completely wrong if the Journal of the American Medical Association (JAMA), as well as other sources, are to be believed.

The Research
After studying a population of 3,681 participants for an average of 7.9 years JAMA concluded that people with low concentrations of salt (sodium) in their urine had an increased risk of dying from cardio vascular problems. They claim that the findings: “do not support the current recommendations of a generalized and indiscriminate reduction of salt intake at the population level."

Similarly, other studies show how low-salt diets lead to:

• higher mortality: An examination of the largest U.S. federal database of nutrition and health (NHANES), published in the Journal of General Internal Medicine, found a higher rate of cardiac events and death with patients put on low-salt diets.
• increased risk of insulin resistance and diabetes shown in a 2010 Harvard study and Australian research.
• greater incidence of falls and cognitive problems among elderly: This is exacerbated by a declining renal function in the aging body causing the kidneys to retain less sodium.
• low birth weights and poor brain development: A 2007 study found that babies with low birth weight also have low sodium in their blood serum because their mothers were on low-salt intakes. Another study found that infants with low sodium may be predisposed to poor neurodevelopmental function a decade later between the ages of 10 and 13.

Confused?

Let’s look at the facts.

The JAMA Study
JAMA is a reputable publication. So I was surprised to note that their research measured the salt level in the urine, NOT, as is usual, in the blood. Sodium in urine is the excess excreted by the kidneys not necessarily the real level. Malfunctioning kidneys will also result in an abnormal sodium level.

Also, their finding are based on 84 deaths out of 3,681 - of which 50 were in the low salt excretion group, 24 in a medium and 10 in a high.

I ask you, are 50 deaths out of 3,681 statistically significant? And how do we know that kidney problems were not the issue with those?

My point is, if it were not for the other studies which did take blood serum samples, I would not give the JAMA conclusions alone much weight.

Role of Salt/Sodium in the Body
Salt/sodium is a key electrolyte. It generates critical electrical signals required for the proper functioning of many processes in the body, especially in the brain, nervous system, and muscles. Sodium maintains the right blood pressure, proper fluid balance and transmission of various nutrients into cells.

Therefore, too much or too little sodium can cause cells to malfunction. Extremes in the blood sodium levels (too much or too little) can be fatal.

As with everything in our body, it is this balance that is critical.

So the question is not so much: ‘To salt or not to salt”, but rather, “What is the right level appropriate for you?

How Much Sodium is Right for You?
You can answer that via a simple blood test and by listening to your body.

A ‘normal’ blood sodium level is 135 - 145 milliEquivalents/liter (mEq/L), or in international units, 135 - 145 millimoles/liter (mmol/L). This needs to be put into the context of your lifestyle, general health, and common sense!

Don't assume a low sodium diet is beneficial for everyone in general and to you in particular. Rather, sodium is good and necessary in moderation dependent on your unique circumstances.

So if you live in a very hot climate &/or sweat a lot, exercise regularly, experience confusion, hallucinations, convulsions, fatigue, headache, muscle spasms or cramps, nausea, restlessness, or vomiting you may need more sodium. If you have heart or kidney complications and edema you may need less.

My father for example, had severe muscle spasms and breathing difficulties. He dealt with this brilliantly! He was Polish and he regularly visited the Wieliczka Polish salt mine renowned to help and even cure respiratory complaints.

On his return (with a newly ‘infused’ salt pipe every time) he would proclaim that he was a “Rejuvenated man”!